The investigation of the effects of topiramate on the hypothalamic levels of fat mass/obesity-associated protein and neuropeptide Y in obese female rats

Objective: The aim of the present study is to investigate the effects of topiramate on the fat mass/obesity-associated protein (FTO) and on the neuropeptide Y (NPY) level in the hypothalamus depending on the recently increased prevalence of obesity.

Method: In this study, twenty-four female rats were divided into four equal groups: Non-obese control, obese control, non-obese topiramate, and obese topiramate. Obese groups were fed with a 40% high-fat diet. At the end of the 9th week, the drug treatment started and the subjects were treated with topiramate once a day for 6 weeks. All animals underwent cardiac perfusion under high-dose anesthesia on the 15th week. Tissues were analyzed using biochemical, histological, and stereological methods.

Results: In terms of neuron number in the arcuate nucleus area, a significant difference was observed among all groups (P?<?0.01). The neuron number of the non-obese topiramate group was found to be significantly higher than that of the non-obese control group (P?<?0.01). In the examination of the ventromedial nucleus of the entire group, it was observed that the neuron number of the non-obese control group was significantly lower than those of the other groups (P?<?0.01). A significant increase in the NPY levels of the obese groups compared to the groups treated with topiramate was observed. Furthermore, the amount of the FTO protein increased in obese rats, while FTO and NPY levels decreased in the groups treated with topiramate.

Discussion: In conclusion, the mechanism of the effect of topiramate to create a state of obesity is thought to involve the decrease in the levels of NPY and FTO.     

Mandibular involvement of solitary plasmocytoma: a case report

Plasma cell neoplasms (multiple myeloma, solitary plasmocytoma of bone and extra medullar plasmocytoma) are characterized by a monoclonal neoplastic proliferation of plasma cells. Solitary plasmocytoma of bone (SPB) is a localized form of them. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare and when it is seen, angulus and ramus mandible are most common sites of occurrence. Prognosis of SPB is worse than extra medullar plasmacytoma (EMP) and approximately 50% of SPB will transform to multiple myelom. A 76-year old woman consulted to our clinic with a chief complaint of slowly developed swelling in her mandible. She had an operation from caput femur because of plasmocytoma two months before. Panoramic radiography revealed a radiolucent lesion in the mandibular anterior region, 60x35 mm in dimension. Aspiration biopsy was performed and histopathological examination was reported as plasmocytoma. She was referred to the oncology department for treatment but died before the treatment finished.     

Maxillary sinus floor augmentation in patients with maxillary sinus pseudocyst: case report

The maxillary sinus floor elevation procedure has gained popularity with predictable results, and is a safe, acceptable technique for bone augmentation, providing a base for dental implant treatment. Faint radiopaque lesions at the base of the maxillary sinus are frequent diagnoses on radiographs and must be identified during dental implant planning. Pseudocysts classically appear hemispheric, homogeneously opaque, and well delineated in panoramic and periapical radiographs. The great majority of these lesions are asymptomatic and do not require surgical treatment. In this case report, we present 4 patients who had a maxillary sinus floor elevation procedure using either crestal or lateral approaches in the presence of antral pseudocysts. No complications were encountered during follow-up periods in these patients and all implants are functioning successfully.     

Nonextraction treatment with rapid maxillary expansion and mandibular symphyseal distraction osteogenesis and vertical skeletal dimensions

OBJECTIVE: To investigate the effects of rapid maxillary expansion (RME) and mandibular symphyseal distraction osteogenesis (MSDO) on vertical dimensions of the face. MATERIALS AND METHODS: Fourteen patients, nine girls and five boys, underwent RME and MSDO procedures. Distraction was carried out at a rate of 1 mm per 24 hours with a tooth-borne appliance. The amount of distraction was 7 mm for each patient. Standardized lateral cephalograms were taken at the following time periods: before treatment (T0), after RME (T1), at the completion of MSDO (T2), and at the end of fixed orthodontic treatment (T3). The data were evaluated by using a general linear model of repeated-measures analysis of variance and paired t-tests at the 95% confidence level. RESULTS: RME significantly increased the vertical dimensions of the face and decreased the overbite (P < .001). Although the vertical parameters of the face on the lateral cephalogram decreased after MSDO, these decreasing effects were statistically insignificant just for the distances measured from the horizontal reference line to the chin points. In other words, MSDO decreased the vertical skeletal dimensions that were increased by RME, but this neutralizing effect of MSDO was not as much as the increase caused by RME. CONCLUSION: Treatment modalities (RME, MSDO, and fixed orthodontic treatment) described in this study, in total, had little effect on the vertical skeletal measurements of the face.     

Mandibular symphyseal distraction osteogenesis: review of three techniques

Mandibular symphyseal distraction osteogenesis (MSDO) is an alternative strategy to correct mandibular transverse deficiencies and dental crowding. Only a limited number of practitioners have reported their clinical experience and potential complications of this procedure to widen the mandible in a large case series. This study involved retrospective analysis of 40 patients who underwent mandibular symphyseal distraction osteogenesis. Three different types of distractor were used to widen the mandible: tooth-borne in 21 patients, bone-borne in 5 patients and hybrid (both bone and tooth-borne) in 14 patients. The distraction amount ranged from 7 to 11 mm (mean 7.31 mm). While 39 patients underwent successful mandibular symphyseal distraction, there was one failure. Most of the complications were experienced in bone-borne distractors, such as breakage of the distractor rod, gingival recession, secondary infection and ptosis of the chin. In the light of these findings, it is suggested that a lingually placed tooth-borne hyrax appliance is more suitable and reliable than the other distraction devices. Further larger studies are needed in order to better evaluate the effectiveness of bone-borne or hybrid devices.     

Incomplete mobilization of the maxilla resulting in failed maxillary distraction: a case report

Maxillary distraction osteogenesis has become an accepted alternative method in the treatment of patients with severe maxillary hypoplasia in craniofacial syndromes and cleft-related deformities. Insufficient distraction, undesirable soft tissue changes, and occurrence of defective distraction vectors are among the potential complications of intraoral maxillary distraction osteogenesis. A 2-stage procedure combining maxillary advancement by distraction technique with genioplasty and mandibular setback surgery was planned to correct jaw deformities in a 22-year-old patient with severe maxillary retrusion, mandibular prognathism, and excessive lower facial height. In the first stage, osteotomies were performed and maxilla was lightly mobilized after down-fracture. Distractors were placed to the maxilla intraorally. During activation period, the maxilla rotated in a clockwise direction, producing a discrepancy between the planned and the actual vectors. Complete distraction was unsatisfactory and the complication was due to surgical technique. This case report presents the failure of maxillary distraction due to incomplete mobilization of the maxilla. Treatment of the case was achieved by the conventional osteotomy techniques at final operation. The maxilla was successfully advanced to the desired position producing good occlusion and an improved facial profile.